Individual
MRS. VLADLENA NISEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
350 HENRY ST, BROOKLYN, NY 11201-6001
(718) 780-1200
Mailing address
8 COBBLERS LN, STATEN ISLAND, NY 10304-4474
(718) 556-0072
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
009215
NY
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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